Harrison's Principles of Internal Medicine (Vol.1
& Vol.2)
21st Edition Newer Edition
Author(s)Joseph Loscalzo; Anthony S. Fauci;
Dennis L. Kasper; Stephen Hauser; Dan Longo; J.
Larry Jameson
TEST BANK
1)
Reference
Ch. 1 — The Practice of Medicine
Question Stem
A 68-year-old man with COPD and stage 3 chronic kidney
disease prefers to avoid hospitalization if possible. Which
,approach best respects the ethical principles of patient-
centered practice while ensuring safe care?
Options
A. Honor his preference and refuse any hospital admission
regardless of clinical deterioration.
B. Discuss goals of care, clarify acceptable risk, and create a
plan for outpatient monitoring and criteria for escalation.
C. Insist on hospitalization because comorbidities always
require inpatient management.
D. Delegate decision-making entirely to family to avoid
distressing the patient.
Correct Answer
B
Rationales
• Correct (B): Shared decision-making aligns with patient-
centered practice: clarify goals, acceptable risks, and an
explicit plan with safety-net criteria for escalation. This
balances respect for autonomy with clinical responsibility.
• A: Absolute refusal of admission ignores potential changes
in condition and clinician duty to ensure safety.
• C: Blanket insistence on admission disregards patient
values and may be nonbeneficent if safe outpatient
options exist.
• D: Delegating decisions entirely to family overrides patient
autonomy unless the patient lacks capacity.
,Teaching Point
Use shared decision-making: clarify goals, risks, and escalation
criteria.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
2)
Reference
Ch. 1 — The Practice of Medicine
Question Stem
A resident must present a diagnostic plan to a supervising
physician. Which element best demonstrates high-value care
when ordering diagnostic tests?
Options
A. Ordering all available tests to ensure nothing is missed.
B. Choosing tests that will change management and avoiding
redundant studies.
C. Ordering only the least expensive tests regardless of
diagnostic yield.
D. Deferring testing until a consultant requests them.
Correct Answer
B
Rationales
, • Correct (B): High-value diagnostic reasoning prioritizes
tests likely to influence management and avoids
redundancy and harm.
• A: Blanket testing increases cost, false positives, and
potential harm without improving care.
• C: Lowest cost alone may miss clinically useful diagnostics;
value is cost plus benefit.
• D: Unnecessary delay can harm patients; clinicians should
act when reasonable rather than awaiting consults.
Teaching Point
Order diagnostics that will change management; avoid
redundant or low-yield testing.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
3)
Reference
Ch. 2 — Promoting Good Health
Question Stem
A primary-care nurse devises a community program to reduce
Type 2 diabetes incidence. Which strategy best applies
population health principles to prevention?
& Vol.2)
21st Edition Newer Edition
Author(s)Joseph Loscalzo; Anthony S. Fauci;
Dennis L. Kasper; Stephen Hauser; Dan Longo; J.
Larry Jameson
TEST BANK
1)
Reference
Ch. 1 — The Practice of Medicine
Question Stem
A 68-year-old man with COPD and stage 3 chronic kidney
disease prefers to avoid hospitalization if possible. Which
,approach best respects the ethical principles of patient-
centered practice while ensuring safe care?
Options
A. Honor his preference and refuse any hospital admission
regardless of clinical deterioration.
B. Discuss goals of care, clarify acceptable risk, and create a
plan for outpatient monitoring and criteria for escalation.
C. Insist on hospitalization because comorbidities always
require inpatient management.
D. Delegate decision-making entirely to family to avoid
distressing the patient.
Correct Answer
B
Rationales
• Correct (B): Shared decision-making aligns with patient-
centered practice: clarify goals, acceptable risks, and an
explicit plan with safety-net criteria for escalation. This
balances respect for autonomy with clinical responsibility.
• A: Absolute refusal of admission ignores potential changes
in condition and clinician duty to ensure safety.
• C: Blanket insistence on admission disregards patient
values and may be nonbeneficent if safe outpatient
options exist.
• D: Delegating decisions entirely to family overrides patient
autonomy unless the patient lacks capacity.
,Teaching Point
Use shared decision-making: clarify goals, risks, and escalation
criteria.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
2)
Reference
Ch. 1 — The Practice of Medicine
Question Stem
A resident must present a diagnostic plan to a supervising
physician. Which element best demonstrates high-value care
when ordering diagnostic tests?
Options
A. Ordering all available tests to ensure nothing is missed.
B. Choosing tests that will change management and avoiding
redundant studies.
C. Ordering only the least expensive tests regardless of
diagnostic yield.
D. Deferring testing until a consultant requests them.
Correct Answer
B
Rationales
, • Correct (B): High-value diagnostic reasoning prioritizes
tests likely to influence management and avoids
redundancy and harm.
• A: Blanket testing increases cost, false positives, and
potential harm without improving care.
• C: Lowest cost alone may miss clinically useful diagnostics;
value is cost plus benefit.
• D: Unnecessary delay can harm patients; clinicians should
act when reasonable rather than awaiting consults.
Teaching Point
Order diagnostics that will change management; avoid
redundant or low-yield testing.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
3)
Reference
Ch. 2 — Promoting Good Health
Question Stem
A primary-care nurse devises a community program to reduce
Type 2 diabetes incidence. Which strategy best applies
population health principles to prevention?
